胸椎骨巨细胞瘤的影像学表现  

Imaging manifestations of giant cell tumor in the thoracic vertebrae

作　　者：许霖[1] 崔博[1] 杜希娜 赵向乾[1] 吕秀花[1] 张彤[1] 杨广夫[2] 

机构地区：[1]第四军医大学西京医院放射科,陕西西安710032 [2]西安交通大学附属西安高新医院放射科

出　　处：《实用放射学杂志》2016年第2期247-250,共4页Journal of Practical Radiology

摘　　要：目的：分析胸椎骨巨细胞瘤的 X 线、CT 和 MRI 影像学特点,提高本病的影像诊断及鉴别诊断能力。方法收集经手术病理证实的9例胸椎骨巨细胞瘤患者的 X 线、CT 和 MRI 资料并对其回顾性分析。7例行 X 线检查,6例行 CT 检查,7例行 MRI检查。结果9例胸椎骨巨细胞瘤中,8例单椎体发病,1例同时累及左侧第9后肋。X 线检查：6例呈溶骨性骨质破坏,1例呈膨胀性骨质破坏；3例边界清楚,3例病变椎体变扁,4例周围见软组织肿块形成。CT 检查：5例呈溶骨性骨质破坏,1例呈膨胀溶骨性骨质破坏；3例边界清楚并可见少许硬化边,4例内见骨嵴影,5例周围见软组织肿块,椎附件、硬膜囊及脊髓不同程度受累及。MRI检查：T1 WI 低信号 5例,等信号2例；T2 WI 等信号 1例,高信号 4例,高低混杂信号2例。结论胸椎骨巨细胞瘤较为少见,应充分分析影像学特点,对提高诊断、指导临床手术治疗及预后有重要的意义。Objective To analyze the X-ray,CT and MRI findings of giant cell tumor in the thoracic vertebrae,in order to improve its diagnostic accuracy.Methods X-ray,CT and MRI findings of 9 cases of pathologically proved giant cell tumor were analyzed retrospectively. X-ray examination was performed in 7 cases,CT in 6 cases,and MRI in 7 cases.Results Of the 9 cases with thoracic vertebrae giant cell tumors,8 involved a single vertebra while 1 case involved the left ninth posterior segment of rib simultaneously.On X-rays studies, 6 cases of bone destruction were dispensability,and 1 case was osteolysis.Three cases of vertebral destructive margin were clear. The body of vertebra was flattened in 3 cases.Pore-vertebral soft tissue masses were found in 4 cases.On CT examinations,5 cases of bone destruction were dispensability,and 1 case was osteolysis.3 cases of vertebral margin were clear with partial sclerotic rim. 4 cases of vertebral body had shade of bone-cristae.There were soft tissue masses around vertebrae in 5 cases,with vertebrae accessory,dural sac and the spinal cord involved to varying degrees.On MRI studies,hypointense were showed in 5 cases while isointense in 2 cases on T1 WI;On T2 WI,isointense was showed in 1 case,hyperintense in 4 cases,and mixed-intense in 2 cases.Conclusion Giant cell tumor in the thoracic vertebrae is uncommon.Full understanding X-ray,CT,MRI characteristics is useful to improve the diagnosis, guide clinical surgical treatment and forecast prognosis.

关 键 词：胸椎 骨巨细胞瘤 计算机体层成像 磁共振成像 

分 类 号：R738.1[医药卫生—肿瘤] R814.42[医药卫生—临床医学]